Provider Demographics
NPI:1467767384
Name:MCATEER, JENNIFER LISA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LISA
Last Name:MCATEER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 NW PENCE LN STE 5
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-6743
Mailing Address - Country:US
Mailing Address - Phone:541-306-1099
Mailing Address - Fax:541-797-5016
Practice Address - Street 1:1740 NW PENCE LN STE 5
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-6743
Practice Address - Country:US
Practice Address - Phone:541-306-1099
Practice Address - Fax:541-797-5016
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR61426225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500695960Medicaid
ORR184633Medicare PIN